A multidisciplinary and multisectoral collaboration, through a One Health approach is required to effectively prepare for, detect, assess, and respond to emerging and endemic zoonotic diseases. However, external and internal health system evaluations continue to identify major gaps in capacity ... to implement multisectoral and multidisciplinary collaboration within and between many countries, and countries are asking for support from the Tripartite to fill these gaps. This guide is the response to those requests.
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Advances have been made through expanded interventions delivered through five public health approaches: innovative and intensified disease management; preventive chemotherapy; vector ecology and management; veterinary public health services; and the provision of safe water, sanitation and hygiene. I...n 2015 alone nearly one billion people were treated for at least one disease and significant gains were achieved in relieving the symptoms and consequences of diseases for which effective tools are scarce; important reductions were achieved in the number of new cases of sleeping sickness, of visceral leishmaniasis in South-East Asia and also of Buruli ulcer.
The report also considers vector control strategies and discusses the importance of the draft WHO Global Vector Control Response 2017–2030.
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To understand the national situation, Ethiopia did a situation assessment, launched its first strategy in 2011, and took action to contain AMR, as detailed in the blue boxes found throughout this strategy. This updated version of the strategy was in response to the revised health and medicines polic...ies, health sector transformation plan, and the resolutions of the 68th World Health Assembly
of May 2015 and so that Ethiopia’s efforts could be coordinated with global initiatives in the prevention and containment of AMR.
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Interim guidance, 6 October 2021
Direct detection of SARS-CoV-2 viral proteins (antigens) in nasal swabs and other respiratory secretions using lateral flow immunoassays (also known as rapid diagnostic tests, RDTs) offers a faster and less expensive method to test for SARS-CoV-2 than the reference ...method, nucleic acid amplification tests (NAATs). This interim guidance offers recommendations on the priority uses of antigen-detecting rapid diagnostic tests (Ag-RDTs) in specific populations and settings, including (i) for primary case detection in symptomatic individuals suspected to be infected and asymptomatic individuals at high risk of COVID-19, (ii) for contact tracing, (iii) during outbreak investigations and (iv) to monitor trends of disease incidence in communities. Ag-RDTs meeting minimum performance requirements can be used outside of clinical and laboratory settings, including in communities, by trained operators in accordance with instructions. The guidance additionally provides recommendations on implementation, product selection and storage.
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Since the release of the first volume in May 2020, the COVID-19 pandemic has continued to rage around the world. By mid-March, 2021, countries around the globe had reported over 123 million cases—a nearly five-fold increase since this report’s previous volume—and over 2.7 million deaths attrib...uted to the disease. And while new case loads are currently on the rise again, the global health community has already administered almost 400 million doses of vaccines, at last offering some signs of hope and progress.
Economic impacts threaten to undo decades of recent progress in poverty reduction, child nutrition and gender equality, and exacerbate efforts to support refugees, migrants, and other vulnerable communities. National and local governments—together with international and private-sector partners—must deploy vaccines as efficiently, safely and equitably as possible while still monitoring for new outbreaks and continuing policies to protect those who do not yet have immunity.
More than ever, the world needs reliable and trustworthy data and statistics to inform these important decisions. The United Nations and all member organizations of the Committee for the Coordination of Statistical Activities (CCSA) collect and make available a wealth of information for assessing the multifaceted impacts of the pandemic. This report updates some of the global and regional trends presented in Volume I and offers a snapshot of how COVID-19 continues to affect the world today across multiple domains.
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5 May 2021
This Information Note is intended to assist national TB programmes and health personnel worldwide to maintain essential tuberculosis (TB) services during the COVID-19 pandemic and in the recovery phase. It is important that recent progress made in TB prevention and care is not reversed b...y COVID-19. The WHO Global TB Programme, along with WHO regional and country offices, developed this note in response to questions received from Member States and other partners since the start of the pandemic. The note includes references to other published WHO information products relevant to TB practitioners. WHO continues to monitor the situation closely for any changes that may influence this note and will issue updates should any factors change.
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- Module 1: Understanding modelling approaches for sexual, reproductive, maternal, newborn, child and adolescent health, and nutrition
Coronavirus disease 2019 (COVID-19) has a wide range of documented effects. It directly causes death and disability for some people infected. However, disruption to... essential health services, resources allocated to mitigation and therefore away from essential health service delivery, and the overall impact on the economy and society must also be considered within the response to COVID-19. Understanding the magnitude of all of these effects is an essential part of developing mitigation polices.
Several epidemiological models have been created to assess the potential impact of disruptions to essential health services caused by COVID-19 on morbidity and mortality from conditions other than COVID-19 illness. This guide presents models that have been used to assess these indirect impacts. The effects have been studied in various settings, using a variety of models.
The guide is intended for people who need to understand what the models say, their construction and their underlying assumptions, or need to use models and their outcomes for planning and programme development and to support policy decisions for a country or region.
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Event-based surveillance (EBS) is defined as the organized collection, monitoring, assessment and interpretation of mainly unstructured ad hoc information regarding health events or risks, which may represent an acute risk to health. Both indicator-based and event-based surveillance components serve... the early warning and response (EWAR) function of the public health surveillance system. The Framework for Event-based Surveillance offers guidance to public health practitioners seeking to implement EBS at each administrative level in healthier countries.
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Hendra virus (HeV) continues to pose a serious public health concern as spillover events occur sporadically. Terminally ill horses can exhibit a range of clinical signs including frothy nasal discharge, ataxia or forebrain signs. Early signs, if detected, can include depression, inappetence, colic o...r mild respiratory signs. All unvaccinated ill horses in areas where flying foxes exist, may potentially be infected with HeV, posing a significant risk to the veterinary community. Equivac® HeV vaccine has been fully registered in Australia since 2015 (and under an Australian Pesticides and Veterinary Medicines Authority special permit since 2012) for immunization of horses against HeV and is the most effective and direct solution to prevent disease transmission to horses and protect humans. No HeV vaccinated horse has tested positive for HeV infection. There is no registered vaccine to prevent, or therapeutics to treat, HeV infection in humans. Previous equine HeV outbreaks tended to cluster in winter overlapping with the foaling season (August to December), when veterinarians and horse owners have frequent close contact with horses and their bodily fluids, increasing the chance of zoonotic disease transmission. The most southerly case was detected in 2019 in the Upper Hunter region in New South Wales, which is Australia's Thoroughbred horse breeding capital. Future spillover events are predicted to move further south and inland in Queensland and New South Wales, aligning with the moving distribution of the main reservoir hosts. Here we (1) review HeV epidemiology and climate change predicted infection dynamics, (2) present a biosecurity protocol for veterinary clinics and hospitals to adopt, and (3) describe diagnostic tests currently available and those under development. Major knowledge and research gaps have been identified, including evaluation of vaccine efficacy in foals to assess current vaccination protocol recommendations.
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Cascading risks from rising prices and supply disruptions, April 2022.
Global resource markets are still reeling from the impacts of Russia’s invasion of Ukraine; the two countries are major suppliers of energy, food and fertilizers. Supply disruption and the sudden imposition, in response to the... crisis, of unprecedented economic sanctions, trade restrictions and policy interventions have caused prices of commodities to skyrocket.
Before the conflict, demand for global resources already exceeded supply and drove up prices as economies rebounded after the COVID-19 pandemic. This gave rise to a global cost-of-living crisis, characterized by increasing levels of energy and food poverty. This situation is likely to become much worse as a consequence of the war in Ukraine, and poses a threat to human security, particularly among low-income and vulnerable populations.
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Following a long recovery from the economic crisis (2007–2013), young people in the EU proved to be more vulnerable to the effects of the restrictions put in place to slow the spread of the COVID-19 pandemic. Young people were more likely than older groups to experience job loss, financial insecur...ity and mental health problems. They reported reduced life satisfaction and mental well-being associated with the stay-at-home requirements and school closures. While governments responded quickly to the pandemic, most efforts to mitigate the effects of restrictions were temporary measures aimed at preventing job loss and keeping young people in education. This report explores the effects of the pandemic on young people, particularly in terms of their employment, well-being and trust in institutions, and assesses the various policy measures introduced to alleviate these effects.
Summary available in 22 languages
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The results of the report clearly show that in 2020, a year dominated by the emergence of COVID-19 and its associated health and economic crises, governments around the world rose to the challenge. Sharp increases in government spending on health at all country income levels underpinned the rise in ...health spending to a new high of US $9 trillion (approximately 11% of global GDP). Government health spending generally increased and offset declines in out-of-pocket spending. Importantly, the rise in government health spending was part of a much broader fiscal response to the pandemic. In high income and upper-middle income countries social protection spending also increased sharply in as governments attempted to cushion populations from the economic impacts of COVID-19. In contrast to health and social protection, growth in education spending was relatively subdued. Countries face the further challenge of sustaining increased public spending on health and other social sectors in the face of deteriorating macroeconomic conditions and rising debt servicing. This also includes the challenge of sustaining external support for low income countries, which is essential for reducing ensuring poverty, ensuring access to health services and strengthening pandemic preparedness.
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WHO needs US$2.54 billion to provide life-saving assistance to millions of people around the world facing health emergencies. WHO’s Health Emergency Appeal is a consolidation of WHO’s priorities and financial requirements for 2023 to carry out health interventions in emergency and humanitarian r...esponses. The number of people in need of humanitarian relief has increased by almost a quarter compared to 2022, to a record 339 million. WHO is responding to an unprecedented number of intersecting health emergencies: climate change-related disasters such as flooding in Pakistan and food insecurity across the Sahel in the greater Horn of Africa; the war in Ukraine; and the health impact of conflict in Yemen, Afghanistan, Syria and north eastern Ethiopia – all of these emergencies overlapping with the health system disruptions caused by the COVID-19 pandemic and outbreaks of measles, cholera, and other killers. Contributions to the appeal can be fully flexible, flexible across a region, or flexible within a country appeal.
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Leptospirosis is a zoonotic disease with epidemic potential, especially after a heavy rainfall,
caused by a bacterium called Leptospira. Leptospira interrogans is pathogenic to humans and
animals, with more than 200 serologic variants or serovars. Humans usually acquire
leptospirosis through dire...ct contact with the urine of infected animals or a urine-contaminated
environment. Human-to-human transmission occurs only very rarely. Leptospirosis may present
with a wide variety of clinical manifestations, from a mild illness that may progress to a serious
and sometimes fatal disease. Its symptoms may mimic many diseases, such as influenza,
dengue and other viral haemorrhagic diseases; making the correct diagnosis (clinical and
laboratory) at the onset of symptoms is important to prevent severe cases and save lives,
primarily in outbreak situations.
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For the past years, Haiti has been engulfed in a socioeconomic, political, and humanitarian crisis that has reached critical levels since mid-September 2022 with the intensification of gang violence and social unrest. The widespread insecurity and
political instability have drastically affected the... country’s access to essential goods and services, including food, water, and health. The current fuel supply crisis has affected the water and electricity supply to the population, health centers, and hospitals. Due to problems of insecurity and violence, patients and health personnel have difficulty accessing hospitals and health services.
In parallel, the public health system and international partners face limited response capacity due to reduced international personnel in Haiti, logistics issues, and difficulties in importing supplies. Indeed insecurity, roadblocks, and lockdowns are affecting the importation of internationally procured goods, which may slow the arrival of essential lifesaving supplies to support cholera response efforts. This scenario is particularly problematic, as cholera recently resurfaced in early October.
Armed gangs now control over 60% of the metropolitan area of Port-au-Prince, affecting at least 1.5 million people, and have expanded their influence outside of the capital city, interrupting vital humanitarian programs in most of the national territory,
including COVID-19 vaccination campaigns.
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Vector-borne diseases are responsible for 17% of the global burden of communicable diseases and more than 500 000 deaths annually. The ambitious global targets for the control of vector-borne diseases come in the context of the (re-)emergence of diseases, increasing resistances to insecticides and u...ncertainty related to the financing of global vector control efforts. The United Nations 2030 Agenda with its related Sustainable Development Goals (SDGs), the New Urban Agenda adopted at the United Nations Conference on Housing and Sustainable Urban Development (Habitat III)
in Quito in 2016 and WHO’s Global vector control response 2017–2030 (WHO, 2017a) emphasize the value of elevating multisectoral actions and strategies that extend beyond the health sector to the core of integrated vector control.
This policy brief underlines the important role housing conditions have in the transmission of vector-borne diseases and showcases interventions and policies the housing sector can contribute to effective, integrated and intersectoral vector-borne diseases management.
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WHO has published the first-ever guidance on the clinical management of diphtheria. The only previously available guidance was an operational protocol. The new guidance followed the rigorous process for developing guidance at WHO.
It addresses the use of Diphtheria Antitoxin (DAT) in the treatmen...t of diphtheria. There is a worldwide shortage of DAT and evidence based recommendations on the use of DAT were requested by many Member States.
The guidance also includes new recommendations on antibiotics. In patients with suspected or confirmed diphtheria, WHO recommends using macrolide antibiotics (azithromycin, erythromycin) rather than penicillin antibiotics.
This clinical practice guideline has been rapidly developed recognizing the global increase in diphtheria outbreaks. Outbreaks of diphtheria in Nigeria, Guinea and neighbouring countries in 2023 have highlighted the urgent need for evidence-based clinical practice guidelines for the treatment of diphtheria. Given the sporadic nature of outbreaks, many clinicians in the affected regions have never managed acute diphtheria and its related complications. Diphtheria remains a neglected disease and vaccination is the top priority. At the same time, for patients with diphtheria, access to antibiotics, DAT and supportive care can be lifesaving.
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Through technical consultations with countries and partners, WHO has led the development of Preparedness and Resilience for Emerging Threats Module 1: Planning for respiratory pathogen pandemics. Version 1.0. The Module, currently available as an advanced draft, builds on previous pandemic lessons a...nd guidance, and has the following new elements:
It presents an integrated and efficient respiratory pathogen pandemic planning approach covering both novel pathogens and those known to have pandemic potential;
It enables coherence in addressing pathogen-agnostic and pathogen-specific elements for better preparedness;
It gives an organizing framework including operational stages and triggers for escalation and de-escalation between pandemic preparedness and response periods;
It contextualizes 12 IHR (2005) core capacities within the five components of health emergency preparedness, response and resilience (HEPR), from the respiratory threats perspective; and
It describes the critical sectors for respiratory pathogen pandemic preparedness to trigger multisectoral collaboration.
WHO will finalize and publish this Module after a global technical meeting that will be held on 24-26 April 2023.
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Health system resilience is not an inevitable byproduct of any investment in health but must be intentionally programmed and developed with necessary input, investment and contextualization. This technical product aims to guide national, subnational, and global health actors to operationalize the co...ncept of health system resilience for advancement of universal health coverage, health security and ultimately better health for all. It supports the translation of relevant conceptual guidance and high-level recommendations into practical actions.
The specific objectives are to:
present a concise overview of the concept of health system resilience;
provide a roadmap outlining practical and foundational steps for building health system resilience to be adapted to different contexts;
share examples of actions and tools, including stakeholder roles, to support country application of the roadmap.
The target audience for this work is the various stakeholders involved in strengthening health systems and public health including management of emergencies (from prevention and preparedness to response and recovery) and other public health challenges in countries. This ranges from the donors, policy-makers and decision-makers at global, national and subnational levels to the implementing institutions and line managers of health system functions and services across the health system building blocks.
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Language influences the way we think, how we perceive reality, and how we behave. With respect to HIV, language can embody stigma and discrimination, which impacts access to testing, acquisition of HIV, and engagement with treatment. Language plays a role in supporting respect and empowerment of ind...ividuals, as communities shape how they are referred to and the labels they wish to use. Consideration and use of appropriate language can strengthen the global response to the HIV pandemic by diminishing stigma and discrimination and increasing support and understanding for individuals and communities living with HIV. Comments and suggestions for modifications should be sent to
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